NURS 242 FINAL EXAM
The patient is receiving blood when he suddenly complains of low
back pain and develops diaphoresis and chills. The nurse should:
(select all that apply) - ANSWERS-a. Stop the transfusion
b. Start the normal saline connected to the Y tubing
c. Notify the physician
d. Start normal saline using new IV tubing
ANS:A,C,D
They would stop the blood so Y tubing wouldn't work
Transfusion therapy is the intravenous (IV) administration of which of
the following: (select all that apply) - ANSWERS-a. Whole blood
b. Plasma products
c. Red blood cells (RBC's)
d. Platelets
ANS: All of them
The patient is expected to require intravenous therapy for several
years as treatment for a chronic disease process. Which of the
following would be the best choice for venous access in this patient? -
ANSWERS-a. Peripherally inserted central catheter (PICC)
b. Nontunneled percutaneous central venous catheter
c. Venous implanted port
d. Peripheral IV
,ANS:C
PICC's are taken out around 18 months
Nontunneled means short term
Peripheral would be changed 72-96 hrs
Which of the following are CVAD's? (select all that apply) -
ANSWERS-a. Implanted venous port
b. Peripherally inserted central catheter
c. Saline locks
d. Peripheral intravenous line
ANS:A,B
Both are inserted in arm and wrist
The nurse is preparing continuous IV infusion in the medication
room. As the RN goes to insert the spike end of the IV tubing into the
IV bag, the tubing drops and the spike hits the med counter. The RN
should take which action? - ANSWERS-a. Obtain a new IV bag
b. Obtain new IV tubing
c. Wipe the spike end of the tubing with betadine
d. Scrub the spike end of the tubing with an alcohol swab
ANS:B
Bag still sterile
Sterile technique needed
, True/False: Before initiating a transfusion, there is a double
verification (two person) of the matched unit with the patient's arm
band, blood transfusion record, and the blood band. - ANSWERS-
True
A client who is receiving a blood transfusion rings the call bell for the
nurse. When entering the room, the RN notes that the client is flushed,
dyspneic, and complaining of generalized itching. The RN interprets
that the client is experiencing: - ANSWERS-a. Bacteremia
b. Fluid overload
c. Hypovolemic shock
d. A transfusion reaction
ANS:D
It is a blood transfusion
The hypovolemic shock would have worse symptoms
What should the RN do upon noting bleeding around a dressing at an
IV insertion site? - ANSWERS-a. Discontinue the IV
b. Assess the insertion site
c. Leave the dressing intact, but reinforce it
d. Elevate and apply warm compresses to the extremity
ANS: B
Inspect first
You need to assess
Not best answer
The patient is receiving blood when he suddenly complains of low
back pain and develops diaphoresis and chills. The nurse should:
(select all that apply) - ANSWERS-a. Stop the transfusion
b. Start the normal saline connected to the Y tubing
c. Notify the physician
d. Start normal saline using new IV tubing
ANS:A,C,D
They would stop the blood so Y tubing wouldn't work
Transfusion therapy is the intravenous (IV) administration of which of
the following: (select all that apply) - ANSWERS-a. Whole blood
b. Plasma products
c. Red blood cells (RBC's)
d. Platelets
ANS: All of them
The patient is expected to require intravenous therapy for several
years as treatment for a chronic disease process. Which of the
following would be the best choice for venous access in this patient? -
ANSWERS-a. Peripherally inserted central catheter (PICC)
b. Nontunneled percutaneous central venous catheter
c. Venous implanted port
d. Peripheral IV
,ANS:C
PICC's are taken out around 18 months
Nontunneled means short term
Peripheral would be changed 72-96 hrs
Which of the following are CVAD's? (select all that apply) -
ANSWERS-a. Implanted venous port
b. Peripherally inserted central catheter
c. Saline locks
d. Peripheral intravenous line
ANS:A,B
Both are inserted in arm and wrist
The nurse is preparing continuous IV infusion in the medication
room. As the RN goes to insert the spike end of the IV tubing into the
IV bag, the tubing drops and the spike hits the med counter. The RN
should take which action? - ANSWERS-a. Obtain a new IV bag
b. Obtain new IV tubing
c. Wipe the spike end of the tubing with betadine
d. Scrub the spike end of the tubing with an alcohol swab
ANS:B
Bag still sterile
Sterile technique needed
, True/False: Before initiating a transfusion, there is a double
verification (two person) of the matched unit with the patient's arm
band, blood transfusion record, and the blood band. - ANSWERS-
True
A client who is receiving a blood transfusion rings the call bell for the
nurse. When entering the room, the RN notes that the client is flushed,
dyspneic, and complaining of generalized itching. The RN interprets
that the client is experiencing: - ANSWERS-a. Bacteremia
b. Fluid overload
c. Hypovolemic shock
d. A transfusion reaction
ANS:D
It is a blood transfusion
The hypovolemic shock would have worse symptoms
What should the RN do upon noting bleeding around a dressing at an
IV insertion site? - ANSWERS-a. Discontinue the IV
b. Assess the insertion site
c. Leave the dressing intact, but reinforce it
d. Elevate and apply warm compresses to the extremity
ANS: B
Inspect first
You need to assess
Not best answer
